Compliance with Adult Congenital Heart Disease Guidelines: Are We Following the Recommendations? Congenit Heart Dis 2016 May;11(3):245-53
Date
11/12/2015Pubmed ID
26554543DOI
10.1111/chd.12309Scopus ID
2-s2.0-84979088536 (requires institutional sign-in at Scopus site) 18 CitationsAbstract
OBJECTIVE: As the adult congenital heart disease population increases, poor transition from pediatric to adult care can lead to suboptimal quality of care and an increase in individual and institutional costs. In 2008, the American College of Cardiology and American Heart Association updated the adult congenital heart disease practice guidelines and in 2011, the American Heart Association recommended transition guidelines to standardize and encourage appropriate timing of transition to adult cardiac services. The objective of this study was to evaluate if patient age or complexity of congenital heart disease influences pediatric cardiologists' decision to transfer care to adult providers and to evaluate the compliance of different types of cardiology providers with current adult congenital heart disease treatment guidelines.
DESIGN: A single-center retrospective review of 991 adult congenital heart disease patients identified by ICD-9 code from 2010 to 2012.
SETTING: Academic and community outpatient cardiology clinics.
PATIENTS: Nine hundred ninety-one patients who are 18 years and older with congenital heart disease.
INTERVENTION: None.
OUTCOMES MEASURES: The compliance with health maintenance and transfer of care recommendations in the outpatient setting.
RESULTS: For patients seen by pediatric cardiologists, only 20% had transfer of care discussions documented, most often in younger simple patients. Significant differences in compliance with preventative health guidelines were found between cardiology provider types.
CONCLUSION: Even though a significant number of adults with congenital heart disease are lost to appropriate follow-up in their third and fourth decades of life, pediatric cardiologists discussed transfer of care with moderate and complex congenital heart disease patients less frequently. Appropriate transfer of adults with congenital heart disease to an adult congenital cardiologist provides an opportunity to reinforce the importance of regular follow-up in adulthood and may improve outcomes as adult congenital cardiologists followed the adult congenital heart disease guidelines more consistently than pediatric or adult cardiologists.
Author List
Gerardin JF, Menk JS, Pyles LA, Martin CM, Lohr JLAuthor
Jennifer Gerardin MD Assistant Professor in the Pediatrics department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdolescentAdult
Age Factors
Aged
Aged, 80 and over
Cardiology
Continuity of Patient Care
Guideline Adherence
Heart Defects, Congenital
Humans
Middle Aged
Minnesota
Practice Guidelines as Topic
Practice Patterns, Physicians'
Retrospective Studies
Survivors
Time Factors
Treatment Outcome
Young Adult
